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Flashcards in Quiz 2 Deck (50):
1

Which sites do HSV 1 & 2 prefer?

1 - latent in trigeminal ganglia

2 - latent in sacral ganglia

2

What are the meds for herpes & how do they work & drug forms?

1. Acyclovir - Zovirax
- oral, topical, IV
2. Valacyclovir - Valtrex
- only oral

Prodrugs - prevent viral shedding

3

What is the MCC of severe diarrhea in children?

Rotavirus

Fecal-oral transmission

4

Who gets the rotavirus vaccine & how do you treat when you get it?

3 dose regimen to infants 6-32 wks

Self limiting - rehydration

5

What type of virus is RSV?

RNA

Readily inactivated w/ soap, water & disinfectants

MCC of bronchiolitis & PNA in kids <1yr

6

What is the vaccine & Tx for RSV?

Palivizumab - Synagis


Tx - Ribavirin aerosol

7

What are the 3 environments TB likes to be in?

1. Extracellular - w/in lung cavities
2. Inside granulomas
3. W/in macrophages

8

What phase do TB drugs target?

Growth phase

9

What is typical therapy for TB?

8 weeks of
1. Rifampin
2. Isoniazid
3. Pyrazinamide
4. Ethambutol

Followed by 16 wks of:
1. Rifampin
2. Isoniazid

10

Can you use TB therapy in pregnant ladies & kids?

Pregnant ladies - yes

Kids - don't use Ethambutol <5y/o

11

What is the most common side effect of all TB drugs?

Hepatotoxicity!!!

12

How does isoniazid work?

For TB

interferes w/ mycolic acid (cell wall)

13

What is the problem w/ slow/fast acetylators & isoniazid?

Slow - drug levels rise & may cause peripheral neuropathy

Fast - Make more metabolite & may cause hepatotoxicity

14

What drug interactions should you consider with isoniazid?

2C19 & 2D6

Careful w/ MAOIs

15

What drugs cause your tears to turn red?

Rifampin - TB Tx
Bactericidal
Used in active TB

Also urine & breast milk

16

How does ethambutol work?

Active TB Tx

Inhibits cell wall synthesis

Bacteriostatic

17

How does pyrazinamide work?

Active TB Tx

Effects ATP - disrupts plasma membrane & energy metabolism

Bactericidal

18

ADRs ethambutol

1. Optic neuritis - dec. acuity, scotoma, color blindness, visual defects
2. Hepatotoxicity
3. GI

19

ADRs pyrazinamide

1. Hyperuricemia
2. Hepatotoxicity
3. Loss of glycemic control
4. GI

20

How does streptomycin work?

Aminoglycoside abx

Interrupts formation of proteins

Injectable only

21

ADRs streptomycin

CN VIII
1. Nephrotoxicity
2. Neurotoxicity
3. HOTN
4. Ototoxicity - auditory & vestibular

22

What are the 4-aminoquinolones & when are they used?

1. Chloroquine

For active & prophylactic malaria

23

What are the 4-methanoloquinolines & ADRs?

For active & prophylactic malaria
1. Mefloquine

Works in blood stage

CV changes & seizure inc, CNS

24

What are the 8-aminoquinolines?

1. Primaquine

For active & prophylactic malaria

Careful w/ G6PD deficiency

25

What are the anti-folates for malaria?

1. Atovaquone/Proguanil (Malarone)

For active & prophylactic malaria

Careful in AIDS Pts (NNRTIs, PIs)

26

What are the antimicrobials for malaria?

1. Doxycylcine
2. Tetracycline
3. Clindamycin

Acts on shizonts - delay death mechanism
Only used in combo therapy

27

What are the artemisinin derivatives?

1. Artemether (Coartem)

Short 1/2 life

DO NOT use as monotherapy!

For active malaria

28

What drugs would you use for a protozoal infection?

1. Tinidazole (Tindamax)
2. Iodoquinol (Yodoxin)
3. Paromomycin
4. Metronidazole (Flagyl)

29

What can you treat w/ Metronidazole?

1. C. Diff
2. Amebiasis
3. Giardiasis
4. Trich
5. Anaerobic infections

DO NOT drink!

30

Why are helminth infections worse in kids?

We have Type II immunity

31

What is the MC infestation throughout the world?

Ascaris wormies

32

What classes of drugs would you use for a helminth infection?

1. Benzimidazoles
2. Ivermectin
3. Praziquantel
4. Pyrantel pamoate

33

ADRs Albendazole

Type of Benzimidazole for helminth

1. Bone marrow suppression
2. Inc. liver transaminases
3. HA
4. Inc. ICP
5. Dizziness, vertigo
6. Ab pain, N/V

34

ADRs Ivermectin

For Helminth - aka Stromectol
P-glycoprotein activity can reduce ivermectin levels in CNS

RARE - reactions prob due to wormie dying
1. Pruritis, fever, LN tenderness
2. Tachycardia
3. Eosinophilia, leukocytes dec., Hgb inc.
Get routine blood work!

35

How is Praziquantel metabolized?

Major substrate of CYP3A4

Aka Biltricide

Rifampin dec. Praziquantel levels

36

How do you Tx pinworms?

Pyrantel Pamoate aka Pin-X

Poor oral absorption

GI problems
Careful if hepatic impairment

37

What are the azole antifungals?

1. Triazole - Fluconazole

2. Imidazole - Ketoconazole

38

What do you need to monitor when using Amphotericin B?

1. Kidney & liver function
2. Electrolytes
3. Vital signs 4 hrs post infusion

39

What do you give with amphotericin B to prevent some of the side effects?

1. Acetaminophen
2. Corticosteroid

Also give K supplementation w/ prolonged therapy, load w/ NaCl injection

40

ADRs amphotericin B

1. Fever & chills
2. Tachypnea, stridor
3. Nephrotoxicity
4. Anemia

41

What are the echinocandins?

Micafungin - Mycamine

42

What are the meds for allergic rhinitis?

1. Nasal corticosteroids
2. Singulair
3. Ipratropium nasal spray
4. Cromolyn nasal spray
5. Antihistamines

43

What are the corticosteroids for allergic rhinitis?

Fluticasone nasal - Flonase

Need 1-2 wks of therapy until max efect

44

What the the leukotriene modifiers for allergic rhinitis?

1. Singulair - Montelukast

Improves rhinorrhea, sneezing & congestoin

45

What are the mast cell stabilizers for allergic rhinitis?

1. Cromolyn nasal - NasalCrom

Reduce release of histamine from mast cells

Can work w/in 30 min

46

What are the anticholinergics for allergic rhinitis, how does it work & ADRs?

1. Ipratropium nasal - Atrovent

Blocks parasympathetic nerve effect - Vidian nerve is postganglionic parasympathetic

Can cause xerostomia & taste perversion
Tx of rhinorrhea

47

What are the antihistamines for cold?

1. Claritin - Loratadine

48

What are the decongestants for cold & ADRs?

Pseudoephedrine - Sudafed

1. CV
2. Metabolic
3. CNS
4. Endocrine

49

What are the antitussives for cold?

1. Dextromethorphan - DelSym
Depression of medullary cough center - sigma receptor stimulation
2. Benzonanatate
Intractable cough Tx

50

At what age should children NOT receive OTC cold & cough meds?

<4 y/o